- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.68 / $2,581.76 / $3,693.00
| Facility | | $215.68 | $2,581.76 | $3,693.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,466.39 / $1,466.39 / $3,262.11
| Facility | 50 | $1,466.39 | $1,466.39 | $3,262.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.94 / $231.27 / $489.08
| Professional | | $117.94 | $231.27 | $489.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $1,482.60 / $1,482.60 / $2,824.00
| Professional | 50 | $1,482.60 | $1,482.60 | $2,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $330.41 / $2,329.00 / $4,755.00
| Facility | | $330.41 | $2,329.00 | $4,755.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.71 / $427.17 / $1,194.01
| Professional | | $164.71 | $427.17 | $1,194.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.71 / $224.52 / $440.41
| Facility | | $172.71 | $224.52 | $440.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.23 / $283.23 / $568.08
| Professional | | $283.23 | $283.23 | $568.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.56 / $460.97 / $854.94
| Professional | | $235.56 | $460.97 | $854.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.88 / $236.19 / $6,679.00
| Facility | | $149.88 | $236.19 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $329.70 / $416.61 / $733.90
| Professional | | $329.70 | $416.61 | $733.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.67 / $405.54 / $778.41
| Professional | | $187.67 | $405.54 | $778.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.64 / $661.81 / $2,051.76
| Professional | | $358.64 | $661.81 | $2,051.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,592.00 / $8,425.00
| Facility | | $1,640.00 | $3,592.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $338.66 / $447.50 / $975.42
| Professional | | $338.66 | $447.50 | $975.42 |